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Reduction of Nasal Bone Fracture using Ultrasound Imaging during Surgery

  • Hwang, So-Min (Aesthetic, Plastic and Reconstructive Surgery Center, Good Moonhwa Hospital) ;
  • Pan, Hao-Ching (Aesthetic, Plastic and Reconstructive Surgery Center, Good Moonhwa Hospital) ;
  • Kim, Hong-Il (Aesthetic, Plastic and Reconstructive Surgery Center, Good Moonhwa Hospital) ;
  • Kim, Hyung-Do (Aesthetic, Plastic and Reconstructive Surgery Center, Good Moonhwa Hospital) ;
  • Hwang, Min-Kyu (Aesthetic, Plastic and Reconstructive Surgery Center, Good Moonhwa Hospital) ;
  • Kim, Min-Wook (Aesthetic, Plastic and Reconstructive Surgery Center, Good Moonhwa Hospital) ;
  • Lee, Jong-Seo (Aesthetic, Plastic and Reconstructive Surgery Center, Good Moonhwa Hospital)
  • Received : 2015.08.14
  • Accepted : 2015.12.03
  • Published : 2016.03.20

Abstract

Background: Most nasal bone fractures are corrected using non-invasive methods. Often, patients are dissatisfied with surgical outcomes following such closed approach. In this study, we compare surgical outcomes following blind closed reduction to that of ultrasound-guided reduction. Methods: A single-institutional prospective study was performed for all nasal fracture patients (n=28) presenting between May 2013 and November 2013. Upon research consent, patients were randomly assigned to either the control group (n=14, blind reduction) or the experimental group (n=14, ultrasound-guided reduction). Surgical outcomes were evaluated using preoperative and 3-month postoperative X-ray images by two independent surgeons. Patient satisfaction was evaluated using a questionnaire survey. Results: The experimental group consisted of 4 patients with Plane I fracture and 10 patients with Plane II fracture. The control group consisted of 3 patients with Plane I fracture and 11 patients with Plane II fracture. The mean surgical outcomes score and the mean patient dissatisfaction score were found not to differ between the experimental and the control group in Plane I fracture (p=0.755, 0.578, respectively). In a subgroup analysis consisting of Plane II fractures only, surgeons graded outcomes for ultrasound-guided reduction higher than that for the control group (p=0.007). Likewise, among the Plane II fracture patients, those who underwent ultrasound-guided reduction were less dissatisfied than those who underwent blind reduction (p=0.043). Conclusion: Our study result suggests that ultrasound-guided closed reduction is superior to blind closed reduction in those patients with Plane II nasal fractures.

Keywords

References

  1. Hwang SM, Kim JH, Kim HD, Jung YH, Kim HI. C-arm fluoroscopy for accurate reduction of facial bone fracture. Arch Craniofac Surg 2013;14:96-101. https://doi.org/10.7181/acfs.2013.14.2.96
  2. Lim KW, Kim JC, Kim SH, Kim SH. A clinical and statistical analysis of the facial bone fractures: from 1994 to 1998. J Korean Soc Plast Reconstr Surg 1999;26:1151-9.
  3. Chen RF, Chen CT, Hao Chen C, Liao HT, Chen YR. Optimizing closed reduction of nasal and zygomatic arch fractures with a mobile fluoroscan. Plast Reconstr Surg 2010;126:554-63. https://doi.org/10.1097/PRS.0b013e3181de22b3
  4. Han DS, Han YS, Park JH. A new approach to the treatment of nasal bone fracture: the clinical usefulness of closed reduction using a Carm. J Plast Reconstr Aesthet Surg 2011;64:937-43. https://doi.org/10.1016/j.bjps.2010.12.019
  5. Imai T, Michizawa M, Yamamoto N, Kai T. Closed reduction of mandibular condyle fractures using C-arm fluoroscopy: a technical note. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:e4-9.
  6. Yu MS, Kim BH, Kang SH, Lim DJ. Combined use of crushed cartilage and fibrin sealant for radix augmentation in Asian rhinoplasty. Plast Reconstr Surg 2015;135:293e-300e. https://doi.org/10.1097/PRS.0000000000001114
  7. Lim KR, Kim HI, Ahn SM, Hwang SM, Jung YH, Song JK. Clinical analysis of the nasal bone fracture. J Korean Cleft Palate-Craniofac Assoc 2011;12:81-5.
  8. Gurkov R, Clevert D, Krause E. Sonography versus plain x rays in diagnosis of nasal fractures. Am J Rhinol 2008;22:613-6. https://doi.org/10.2500/ajr.2008.22.3239
  9. Abu-Samra M, Selmi G, Mansy H, Agha M. Role of intra-operative ultrasound-guided reduction of nasal bone fracture in patient satisfaction and patient nasal profile (a randomized clinical trial). Eur Arch Otorhinolaryngol 2011;268:541-6. https://doi.org/10.1007/s00405-010-1401-1

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